Provider Demographics
NPI:1619785623
Name:SHARP, SHIANE
Entity type:Individual
Prefix:
First Name:SHIANE
Middle Name:
Last Name:SHARP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7925 HUNTER RD SW
Mailing Address - Street 2:
Mailing Address - City:AMANDA
Mailing Address - State:OH
Mailing Address - Zip Code:43102-9557
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7925 HUNTER RD SW
Practice Address - Street 2:
Practice Address - City:AMANDA
Practice Address - State:OH
Practice Address - Zip Code:43102-9557
Practice Address - Country:US
Practice Address - Phone:740-215-7815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH402158300419374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide